Previous clinical studies using low dosages of the selective GABA-B receptor agonist baclofen (30-80 mg/d) in alcohol-dependent patients reported divergent results. Preclinical as well as clinical findings suggested a dose-dependent effect of baclofen in modulating alcohol-related behaviors. The BACLAD trial aimed to evaluate the efficacy and safety of individually titrated high-dose baclofen (up to 270 mg/d) for the treatment of alcohol dependence using a randomized, placebo-controlled design. We found that high-dose treatment with baclofen effectively supported alcohol-dependent patients in maintaining abstinence. The medication was well tolerated and no drug-related serious adverse events were observed. In addition to these results, neuroimaging findings concerning the effects of baclofen on neural correlates of alcohol dependence will be presented.